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POLICY CHANGE DOCUMENT <br />POLICY NO.: PHSD1866043-012 <br />Philadelphla Indemnity Insurance Company 26402 PCF Insurance Services of the West, LLC <br />NAMED INSURED Barrios and Associates LLC <br />dba Communications LAB <br />MAILING ADDRESS 701 E Chapman Ave <br />Orange, CA 92866-1620 <br />POLICY PERIOD: FROM 04/01/2025 TO 04/01/2026 at <br />12:01 A.M. Standard Time at your mailing address shown above. <br />CHANGE EFFECTIVE 04/24/2025 CHANGE # 2 REVISION # 2 <br />DESCRIPTION <br />In consideration of the premium reflected, the policy is amended as indicated below: <br />Additional Insured Endorsement (Vicarious Liability) is added to the policy. <br />Path ID 18557808 <br />Total Annual <br />Additional/Return Premium $ <br />IKoPPIIII gC;9cc] 011A01 <br />(Date) <br />Total Prorate <br />0.00 Additional/Return Premium $ <br />NO CHANGE <br />BY <br />(Authorized Representative) <br />0.00 <br />NO CHANGE <br />05/30/2026 <br />Issue Date Insured Copy Page 1 of 1 <br />